Individual provider Active NPI

Jessica Marien Roque Sr.

  • Behavior Technician
  • Miami, FL
National Provider Identifier
1063305258
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-25-438511 Issued in FL
Practice address
2745 SW 6TH St Apt 4
Miami, FL 33135-2871
Phone
(786) 793-7883
Fax
(786) 793-7883
NPI assigned
May 29, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior TechnicianGroup: 193400000X SINGLE SPECIALTY GROUP 106S00000X RBT-25-438511 FL Primary

Addresses

Primary practice location

2745 SW 6TH St Apt 4
Miami, FL 33135-2871

Mailing address

2745 SW 6TH St Apt 4
Apartamento 4
Miami, FL 33135-2871
Phone (786) 793-7883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RBT-25-438511FLMDBehavior Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1063305258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2745 SW 6TH ST APT 4",
            "address_2": "APARTAMENTO 4",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352871",
            "telephone_number": "786-793-7883",
            "fax_number": "786-793-7883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2745 SW 6TH ST APT 4",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331352871",
            "telephone_number": "786-793-7883",
            "fax_number": "786-793-7883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROQUE",
        "first_name": "JESSICA",
        "middle_name": "MARIEN",
        "name_suffix": "Sr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-29",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Technician",
            "state": "FL",
            "license": "RBT-25-438511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.